In keeping with the American penchant for public direction of the country's biomedical research strategy, Congressional representatives Henry Waxman (D-CA) and Connie Morella (R-MD) have introduced legislation requesting the creation of a permanent Office of Autoimmune Diseases within the Office of the Director (OD) at the National Institutes of Health (NIH).

The bill, entitled "NIH Autoimmune Diseases Act of 1999" was submitted on behalf of patient groups represented largely by the American Autoimmune Related Diseases Association (AAARDA). The new Office would cost $950,000 to set up.

There are currently over 30 offices in the OD, and the proposal appears to run contrary to the desires of NIH director Harold Varmus, who would rather consolidate the dozens of NIH institutes, offices and centers than add to them. "There shouldn't be any more independent offices unless there's a good reason," says Varmus, "...consolidation is more productive, and I am resistant to adding more administrative structures than we already have."

Last year, Congress urged the NIH to convene a coordinating committee for autoimmune disease research "to synergize research efforts among the Institutes and facilitate advances in this area." This new committee, which comprises one representative from each NIH institute, reviews NIH-funded research into autoimmune diseases such as lupus, Grave's disease, multiple sclerosis, and type I diabetes that affect an estimated 13.5 million Americans, 75 percent of which are women.

" Stan Hochelmeister, of the grassroots Medical Research Task Force, has successfully lobbied Congress to allocate 500 million dollars for research into a cure for Hochelmeister's disease."

The coordinating committee will spend $30 million in FY99 promoting basic and clinical research that cuts across multiple autoimmune conditions. In addition, the collaborative network for clinical research on immune tolerance (Nature Med. 5, 470; 1999) will also provide a staggering $120 million in funding to support cooperative research studies on tolerance induction in autoimmune patients. But apparently this is still not enough.

"Autoimmune diseases fall into all different Institutes, and are not the single focuses of any one Institute," complains AAARDA's executive director, Virginia Ladd. She says that the main goal of the new office will be to promote the cooperation that is currently lacking between autoimmune disease researchers from different fields, and prevent replication of research projects.

But the researchers in question are not convinced that the addition will have a large impact on their work. Stephen Straus, chief of the National Institutes of Allergy and Infectious Diseases laboratory of Clinical Investigation, says "there are advantages to having a somewhat more focused way of addressing autoimmune diseases but I don't feel that a separate NIH office would be needed to do so."